Articles Posted in Insurance

The Biden Administration’s $1.9 trillion coronavirus pandemic relief law, called the American Rescue Plan, tackles one of the leading concerns expressed by American voters in repeated recent political campaigns: our health and health care. Foes have denounced it as wasteful and unfocused. But it arguably offers common sense federal responses to the worst public health catastrophe in a century.

The Biden measure gives a huge boost to battling the coronavirus itself, providing almost $60 billion for “vaccine and treatment development, manufacturing, distribution, and tracking, as well as Covid-19 testing and contact tracing,” according to media reports.

The Biden package, as the president promised, also expands health insurance coverage under the Affordable Care Act, albeit for at least two years. As the New York Times reported:

bucksfloating-300x167Who wouldn’t want $352 billion in health care savings in 2021?

Insurers — and more importantly employers — could see that hypothetical big chunk of change staying in their pockets, if somehow they could persuade hospitals to forgo their sky-high and ever-increasing prices, tying those charges instead to rates established and paid in the federal Medicare program that covers millions of the nation’s seniors, a new study reported.

The independent Kaiser Family Foundation (KFF) concedes it is unlikely that hospitals, insurers, and businesses would adopt the nonprofit organization’s newly published research any time soon.

brooks-lasure-150x150With millions of Americans now eligible to seek affordable health insurance on Obamacare exchanges newly re-opened to them, even more consumers will want to see if Congress’ impending action on the $1.9 trillion coronavirus pandemic response plan pushed by President Biden further expands coverage options.

The Democrats in Congress have made clear that they hope to get Biden’s financial package passed and in place by mid-March, when earlier approved pandemic plans, notably for unemployment insurance and other economic aid, are set to expire.

Their vote margin is so narrow, however, that they may need to rely on so-called budget reconciliation paths to pass the “American Rescue Plan,” a measure that includes an array of Democratic initiatives, notably those involving their plans to improve the access and affordability of health care, especially with greater coverage of the aged, poor, children, as well as the chronically physically and mentally ill.

corridorhospital-300x200Although politicians have obsessed for a decade about affordable health insurance, frustrated patients have seen little or no relief on another crucial concern — the skyrocketing costs of medical services. What policy paths could best offer dollars-and-cents help to struggling people with health care prices?

New research from the independent, nonpartisan RAND Corporation offers intriguing clues about billions of dollars in annual savings, based on complex modeling of actual options confronting the public and policy makers.

These choices, the experts say, may come to the political fore with new force due to the economic shocks the U.S. health system has been hit with due to the coronavirus pandemic.

autowreck-300x178Congressional investigations may be coming none too soon on revelations about predatory billing by big hospitals and hospital chains against patients for costly care they received after they were hurt in vehicle wrecks.

The New York Times reported that its investigations showed that patients, especially the poor and vulnerable, too often have gotten ripped off on treatments that their health insurance could have covered when they were involved in car crashes. Instead, hospitals and hospital chains seek to maximize profits — and purportedly to protect themselves against financial losses — by making legal claims against wreck victims and their finances.

The claims, permitted under centuries-old practices, are called liens. They are a legal “claim on an asset, such as a home or a settlement payment, to make sure someone repays a debt,” the New York Times reported.

bronzekff-300x264President Biden has increased the access and affordability of health care for millions of Americans, issuing executive orders to reopen Obamacare exchanges and review rules or practices that targeted the aged, poor, sick, and chronically ill or mentally ill and hindered them from benefiting from Medicaid.

These were fast, early actions that Biden campaigned on and said that voters wanted him to take with urgency, as he did.

Allowing a “do over” of ACA enrollment will be a boon for millions of the pandemic jobless, many of whom may have lost employer-provided health insurance (which covers more than 150 million Americans, or most of us) and could not afford the daunting prices of so-called COBRA policies. That coverage requires consumers to may their own share of health insurance, plus the big chunk their employers cover, as well as an administrative fee.

negron-150x150melgen-150x150bernadett-150x150President Trump’s term ended with a spree of executive clemency to health care crooks who ripped off taxpayers and harmed patients.

His last-minute actions infuriated advocates for health care reform and patient protection, as well as federal prosecutors. They were aghast by the inexplicable largess shown to Medicare and medical miscreants included in Trump’s last-minute, public pardons of 73 people and commutations for 70 others. 

The white collar crooks not only got get-out-of-jail-free cards from Trump, but also saw their debts to the government canceled to the tune of millions of dollars.

kneelady-300x222With so many older Americans entering their later years in better shape than earlier generations and wanting to stay active, knee and hip replacements have become some of the most common surgeries performed in pre-pandemic times. The cost of this work, however, varies greatly. And surgeons may be promoting procedural variants to not only build business but also to increase their revenue for these operations.

Consumers, policy makers, regulators, and politicians may want to keep an eye on developments with patients’ knees and hips as indicators of what may occur in health care finances, especially if hospitals’ case loads return to something of a pre-pandemic norm and because taxpayers bear burdens from so many of the Medicare-covered procedures.

New data is emerging about hospital costs as the institutions, many of them overwhelmed now by the coronavirus pandemic, comply with Trump Administration price-disclosure regulations. These called for hospitals to post online their base costs (as earlier described in the hard-to-read charge master lists) for hundreds of common procedures and medical items, as well as previously secret prices for same, as negotiated with insurers.

dcemptystreets-300x200Auto insurance companies and agents may have sent customers cards, fridge magnets, or calendars as part of their holiday cheer. But tens of millions of motorists may wish to demand more — both much more, and less.

Consumer advocates say the coronavirus pandemic has curtailed driving and claims for wrecks enough still that auto insurers — who are raking in big profits — need in the new year to fork over more refunds or premium reductions, the New York Times reported.

The newspaper reported that advocacy organizations like the Consumer Federation of America and the Center for Economic Justice, have investigated and “found that car crashes remained ‘well below’ 2019 levels”:

compare-202x300A lot of people in health care across the country are firing up their computers to dig into long-sought, confidential information from hospitals about their prices and deals they cut on them with an array of parties.

As the Wall Street Journal reported, the Trump Administration successfully battled with hospitals to get them to disclose previously secret pricing data, in the hopes that disclosing this key information will benefit the U.S. health care system, notably in curbing costs. Here’s why, as the newspaper reported:

“T]hose who pay for health-care premiums and medical bills — employers, workers and patients — were long in the dark about wide price differences among hospitals for the same service in the same city, according to research and efforts by large employer groups to compare prices. Hospital prices are under intense scrutiny as the sector consolidates and research points to price increases after mergers, but without the quality gains that hospitals often cite as rationale for the combinations.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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